World and Nation

Short of repeal, Republicans will chip away at health care

WASHINGTON — Republicans are serious. Hopeful of picking up substantial numbers of seats in the congressional elections, they are developing plans to try to repeal or roll back President Barack Obama’s new health care law.

This goal, although not fleshed out in a detailed legislative proposal, is much more than a campaign slogan. That conclusion emerged from interviews with a range of Republican lawmakers, who said they were determined to chip away at the law if they could not dismantle it.

House Republicans are expected to include specifics in an election agenda they intend to issue Thursday. Although they face tremendous political and practical hurdles to undoing a law whose provisions are rapidly going into effect, they are laying the groundwork for trying.

For starters, Republicans say they will try to withhold money that federal officials need to administer and enforce the law. They know that even if they managed to pass a wholesale repeal, Obama would veto it.

“They’ll get not one dime from us,” the House Republican leader, John A. Boehner of Ohio, told The Cincinnati Enquirer recently. “Not a dime. There is no fixing this.”

Republicans also intend to go after specific provisions. Sen. Orrin G. Hatch of Utah, a senior Republican on the Finance Committee, has introduced a bill that would eliminate a linchpin of the new law: a requirement for many employers to offer insurance to employees or pay a tax penalty. Many Republicans also want to repeal the law’s requirement for most Americans to obtain health insurance.

Alternatively, Republicans say, they will try to prevent aggressive enforcement of the requirements by limiting money available to the Internal Revenue Service, which would collect the tax penalties.

Republicans say they will also try to scale back the expansion of Medicaid if states continue to object to the costs of adding millions of people to the rolls of the program for low-income people.

In addition, Republican lawmakers may try to undo some cuts in Medicare, the program for older Americans. Many want to restore money to Medicare’s managed care program and clip the wings of a new agency empowered to recommend cuts in Medicare. Recommendations from the agency, the Independent Payment Advisory Board, could go into effect automatically unless blocked by subsequent legislative action.

Rep. Michael C. Burgess, R-Texas, a physician, acknowledged that repealing the law becomes more difficult with each passing week, as various provisions take effect and are woven into “the fabric of American life.”

Michael A. Needham, chief executive of Heritage Action for America, who is leading a campaign for repeal, said, “There will be technical challenges in unwinding the legislation.”

Many Republican candidates for Congress have emphasized their desire to repeal the health care law. Their vow is an election issue, and more — a commitment they mean to pursue, regardless of the election results.